EURADOS project on the impact of the proposed ICRU operational dose quantities.

Following the publication of the joint The International Commissions on Radiation Units and Measurements (ICRU) and on Radiological Protection (ICRP) report on new operational quantities for radiation protection, the European Dosimetry Group (EURADOS) have carried out an initial evaluation. The EURADOS report analyses the impact that the new quantities will have on: radiation protection practice; calibration and reference fields; European and national regulation; international standards and, especially, dosemeter and instrument design. The task group included experienced scientists drawn from across the various EURADOS working groups.

Recommendations for the use of active personal dosemeters (APDs) in interventional workplaces in hospitals.

Occupational radiation doses from interventional procedures have the potential to be relatively high. The requirement to optimise these doses encourages the use of electronic or active personal dosimeters (APDs) which are now increasingly used in hospitals. They are typically used in tandem with a routine passive dosimetry monitoring programme, with APDs used for real-time readings, for training purposes and when new imaging technology is introduced.

EURADOS STRATEGIC RESEARCH AGENDA 2020: VISION FOR THE DOSIMETRY OF IONISING RADIATION.

Since 2012, the European Radiation Dosimetry Group (EURADOS) has developed its Strategic Research Agenda (SRA), which contributes to the identification of future research needs in radiation dosimetry in Europe. Continued scientific developments in this field necessitate regular updates and, consequently, this paper summarises the latest revision of the SRA, with input regarding the state of the art and vision for the future contributed by EURADOS Working Groups and through a stakeholder workshop. Five visions define key issues in dosimetry research that are considered important over at least the next decade.

Absorbed dose in the operator's brain in interventional radiology practices: evaluation through KAP value conversion factors.

In order to address the recent concerns over a possible increasing in brain tumour mortality among interventional radiologists and cardiologist, this work evaluated the exposure conditions of the operator's brain during interventional procedures using Monte Carlo simulations with anthropomorphic phantoms. The absorbed doses in several predefined segments of the operator's brain were estimated in a typical interventional radiology irradiation scenario. The doses were normalized to the KAP values simulated for ten X-ray beam qualities and four projections (PA, RAO 25°, LAO 25° and CRA 25°).

THE USE OF ACTIVE PERSONAL DOSEMETERS IN INTERVENTIONAL WORKPLACES IN HOSPITALS: COMPARISON BETWEEN ACTIVE AND PASSIVE DOSEMETERS WORN SIMULTANEOUSLY BY MEDICAL STAFF.

Medical staff in interventional procedures are among the professionals with the highest occupational doses. Active personal dosemeters (APDs) can help in optimizing the exposure during interventional procedures. However, there can be problems when using APDs during interventional procedures, due to the specific energy and angular distribution of the radiation field and because of the pulsed nature of the radiation.

EURADOS education and training activities.

This paper provides a summary of the Education and Training (E&T) activities that have been developed and organised by the European Radiation Dosimetry Group (EURADOS) in recent years and in the case of Training Courses over the last decade. These E&T actions include short duration Training Courses on well-established topics organised within the activity of EURADOS Working Groups (WGs), or one-day events integrated in the EURADOS Annual Meeting (workshops, winter schools, the intercomparison participants' sessions and the learning network, among others). Moreover, EURADOS has recently established a Young Scientist Grant and a Young Scientist Award.

SESAME: A TOOL FOR NUMERICAL DOSIMETRIC RECONSTRUCTION OF PATIENTS OVEREXPOSURES IN INTERVENTIONAL RADIOLOGY.

Radiation overexposure accidents are rare but can have severe health consequences. Evaluating the dose received by the patient is a crucial step in the medical management. For that purpose, for more than 15 years, IRSN has been developing an in-house tool named SESAME for the numerical reconstruction of radiological accidents due to external sources.

EURADOS 2016 INTERCOMPARISON EXERCISE OF EYE LENS DOSEMETERS.

In the context of a new annual eye lens dose limit for occupational exposure equal to 20 mSv, European Radiation Dosimetry Group (EURADOS) organized an intercomparison dedicated to eye lens dosemeters, including photon and beta radiations. The objective was to complete the first intercomparison recently organized by EURADOS for photons and to update the overview of eye lens dosemeters available in Europe. The dosemeters provided by the 22 participants coming from 12 countries were all composed of thermoluminescent detectors.

Effect of the radiation protective apron on the response of active and passive personal dosemeters used in interventional radiology and cardiology.

In fluoroscopy guided interventional procedures, workers use protective garments and often two personal dosemeters, the readings of which are used for the estimation of the effective dose; whereas the dosemeter above the protection can be used for the estimation of the equivalent dose of the lens of the eye. When a protective apron is worn the scattered field that reaches the dosemeter is different from the case where no protection is used; this study analyses the changes in the response of seven passive and eight active personal dosemeters (APDs) when they are placed above a lead or lead equivalent garment for S-Cs and x-ray diagnostic qualities. Monte Carlo simulations are used to support the experimental results.

SIMULATION OF EARLY RADIATION-INDUCED DNA DAMAGE ON DIFFERENT TYPES OF CELL NUCLEI.

This work presents a comparison of simulated early radiation-induced DNA damage represented by yields of double-strand breaks (DSB) in three different human cell nuclei geometries representing fibroblasts, lymphocytes and endothelial cells for protons and alpha particles of different energies and for different irradiation configurations. Each cell nucleus model includes a multi-scale description of the DNA target from the molecular level to the whole human genome representation (6 Gbp) in the G0/G1 phase of the cell cycle and was generated with the DnaFabric software. The three nuclei differ in shape, volume, and therefore DNA density.

Characterisation of two new radiochromic gel dosimeters TruView™ and ClearView™ in combination with the vista™ optical CT scanner: A feasibility study.

Purpose: This study aims at characterising the properties of TruView™ and ClearView™ two new gel dosimeters (Modus Medical Devices Inc.) and at studying the feasibility of relative dosimetry using these dosimeters and the Vista™ Optical CT scanner to accurately evaluate dose.

Methods: In this work, we investigated key dosimetric aspects (dose response, energy and dose rate dependence) and stability of these radiochromic gels initiated in preliminary works (Huet et al.

Simulation of early DNA damage after the irradiation of a fibroblast cell nucleus using Geant4-DNA.

In order to improve the understanding of the mechanisms involved in the generation of early DNA damage, a new calculation chain based on the Geant4-DNA toolkit was developed. This work presents for the first time the simulation of the physical, physicochemical and chemical stages of early radiation damage at the scale of an entire human genome (fibroblast, male) and using Geant4-DNA models. The DnaFabric software was extended to generate and export this nucleus model to a text file with a specific format that can be read by Geant4 user applications.

The influence of operator position, height and body orientation on eye lens dose in interventional radiology and cardiology: Monte Carlo simulations versus realistic clinical measurements.

Objective: This paper aims to provide some practical recommendations to reduce eye lens dose for workers exposed to X-rays in interventional cardiology and radiology and also to propose an eye lens correction factor when lead glasses are used.

Methods: Monte Carlo simulations are used to study the variation of eye lens exposure with operator position, height and body orientation with respect to the patient and the X-ray tube. The paper also looks into the efficiency of wraparound lead glasses using simulations.

Study of commercial detector responses in non-equilibrium small photon fields of a 1000MU/min CyberKnife system.

Purpose: The purpose of this study was to analyze the detector responses in non-equilibrium small photon fields.

Methods: Five detectors (PTW 31014 ionization chamber, PTW 60016, PTW 60017 and Sun Nuclear EDGE diodes and PTW 60003 diamond detector) and one passive dosimeter (Harshaw micro-LiF) as well as a 1000MU/min CyberKnife were modeled with the PENELOPE Monte Carlo code. Field factors, [Formula: see text] were calculated and perturbations due to volume averaging effect, active material effect and coating effect were quantified for the five detectors and passive dosimeter.

Influence of beam incidence and irradiation parameters on stray neutron doses to healthy organs of pediatric patients treated for an intracranial tumor with passive scattering proton therapy.

Purpose: In scattering proton therapy, the beam incidence, i.e. the patient's orientation with respect to the beam axis, can significantly influence stray neutron doses although it is almost not documented in the literature.

EURADOS INTERCOMPARISONS IN EXTERNAL RADIATION DOSIMETRY: SIMILARITIES AND DIFFERENCES AMONG EXERCISES FOR WHOLE-BODY PHOTON, WHOLE-BODY NEUTRON, EXTREMITY, EYE-LENS AND PASSIVE AREA DOSEMETERS.

The European Radiation Dosimetry Group (EURADOS) has been organising dosimetry intercomparisons for many years in response to an identified requirement from individual monitoring services (IMS) for independent performance tests for dosimetry systems. The participation in intercomparisons gives IMS the opportunity to show compliance with their own quality management system, compare results with other participants and develop plans for improving their dosimetry systems. In response to growing demand, EURADOS has increased the number of intercomparisons for external radiation dosimetry.

Cell to Cell Variability of Radiation-Induced Foci: Relation between Observed Damage and Energy Deposition.

Most studies that aim to understand the interactions between different types of photon radiation and cellular DNA assume homogeneous cell irradiation, with all cells receiving the same amount of energy. The level of DNA damage is therefore generally determined by averaging it over the entire population of exposed cells. However, evaluating the molecular consequences of a stochastic phenomenon such as energy deposition of ionizing radiation by measuring only an average effect may not be sufficient for understanding some aspects of the cellular response to this radiation.

Characterisation of grids of point detectors in maximum skin dose measurement in fluoroscopically-guided interventional procedures.

Purpose: Point detectors are frequently used to measure patient's maximum skin dose (MSD) in fluoroscopically-guided interventional procedures (IP). However, their performance and ability to detect the actual MSD are rarely evaluated. The present study investigates the sampling uncertainty associated with the use of grids of point detectors to measure MSD in IP.

FIRST EURADOS INTERCOMPARISON EXERCISE OF EYE LENS DOSEMETERS FOR MEDICAL APPLICATIONS.

In the context of the decrease in the eye lens dose limit for occupational exposure to 20 mSv per year stated by the recent revision of the European Basic Safety Standards Directive 2013/59/EURATOM, the European Radiation Dosimetry Group (EURADOS) has organised in 2014, for the first time, an intercomparison exercise for eye lens dosemeters. The main objective was to assess the capabilities of the passive eye lens dosemeters currently in use in Europe for occupational monitoring in medical fields. A total of 20 European individual monitoring services from 15 different countries have participated.

Characterization of XR-RV3 GafChromic(®) films in standard laboratory and in clinical conditions and means to evaluate uncertainties and reduce errors.

Purpose: To investigate the optimal use of XR-RV3 GafChromic(®) films to assess patient skin dose in interventional radiology while addressing the means to reduce uncertainties in dose assessment.

Methods: XR-Type R GafChromic films have been shown to represent the most efficient and suitable solution to determine patient skin dose in interventional procedures. As film dosimetry can be associated with high uncertainty, this paper presents the EURADOS WG 12 initiative to carry out a comprehensive study of film characteristics with a multisite approach.

Risk of eye lens radiation exposure for members of the public.

In 2011, the International Commission on Radiological Protection (ICRP) reviewed its recommendation concerning the equivalent dose limit for the eye lens, lowering it to 20 mSv in a year, for occupational exposure in planned exposure situations. The ICRP's statement does not contain any explicit recommendations regarding the organ dose limit for the eye lens for public exposure. For the moment, no change is proposed.

Configuration and validation of an analytical model predicting secondary neutron radiation in proton therapy using Monte Carlo simulations and experimental measurements.

Purpose: This study focuses on the configuration and validation of an analytical model predicting leakage neutron doses in proton therapy.

Methods: Using Monte Carlo (MC) calculations, a facility-specific analytical model was built to reproduce out-of-field neutron doses while separately accounting for the contribution of intra-nuclear cascade, evaporation, epithermal and thermal neutrons. This model was first trained to reproduce in-water neutron absorbed doses and in-air neutron ambient dose equivalents, H*(10), calculated using MCNPX.

Application of the ELDO approach to assess cumulative eye lens doses for interventional cardiologists.

In preparation of a large European epidemiological study on the relation between eye lens dose and the occurrence of lens opacities, the European ELDO project focused on the development of practical methods to estimate retrospectively cumulative eye lens dose for interventional medical professionals exposed to radiation. The present paper applies one of the ELDO approaches, correlating eye lens dose to whole-body doses, to assess cumulative eye lens dose for 14 different Finnish interventional cardiologists for whom annual whole-body dose records were available for their entire working period. The estimated cumulative left and right eye lens dose ranged from 8 to 264 mSv and 6 to 225 mSv, respectively.

Measurement of maximum skin dose in interventional radiology and cardiology and challenges in the set-up of European alert thresholds.

To help operators acknowledge patient dose during interventional procedures, EURADOS WG-12 focused on measuring patient skin dose using XR-RV3 gafchromic films, thermoluminescent detector (TLD) pellets or 2D TL foils and on investigating possible correlation to the on-line dose indicators such as fluoroscopy time, Kerma-area product (KAP) and cumulative air Kerma at reference point (CK). The study aims at defining non-centre-specific European alert thresholds for skin dose in three interventional procedures: chemoembolization of the liver (CE), neuroembolization (NE) and percutaneous coronary interventions (PCI). Skin dose values of >3 Gy (ICRP threshold for skin injuries) were indeed measured in these procedures confirming the need for dose indicators that correlate with maximum skin dose (MSD).

Efficiency of radiation protection equipment in interventional radiology: a systematic Monte Carlo study of eye lens and whole body doses.

Monte Carlo calculations were used to investigate the efficiency of radiation protection equipment in reducing eye and whole body doses during fluoroscopically guided interventional procedures. Eye lens doses were determined considering different models of eyewear with various shapes, sizes and lead thickness. The origin of scattered radiation reaching the eyes was also assessed to explain the variation in the protection efficiency of the different eyewear models with exposure conditions.